<?php
  require_once('includes/db.php');
  require_once('includes/header.php'); 
?>
      <!-- Main component for a primary marketing message or call to action -->
      <div class="jumbotron" style="padding: 10px;">
        <h4>Please fill the details below:-</h4>

      </div>
      <div style="width:380px;">
      
<!-------Register Form Starts Here ----------->      
      <form id="registerId" action="saveuser.php" method="post" enctype="multipart/form-data">

        <div class="form-group">
          <label>Name</label>
          <input type="text" class="form-control"  placeholder="Enter Name" name="uname">
        </div>

        <div class="form-group">
          <label>Email</label>
          <input type="email" class="form-control" placeholder="Email" name="email">
        </div>

        <div class="form-group">
          <label>Password</label>
          <input type="password" class="form-control" placeholder="Password" name="password" id="passwordId">
        </div>

        <div class="form-group">
          <label>Confirm Password</label>
          <input type="password" class="form-control" placeholder="Confirm Password" name="cpassword">
        </div>

        <div class="form-group">
          <label>Select Gender</label>
          <div class="radio">
            <label>
              <input type="radio" name="gender"  value="m">
              Male
            </label>
          </div>
          <div class="radio">
            <label>
              <input type="radio" name="gender"  value="f">
              Female
            </label>
          </div>
          <div><label class="alert-danger" generated="true" for="gender"></label></div>
        </div><!-- end form-group gender-->

        <div class="form-group">
          <label>Date Of Birth</label>
          <input type="text" class="form-control" placeholder="__-__-____" name="dob" id="dobId">
        </div>

        <div class="form-group">
          <label>Country</label>
          <select name="country_id" class="form-control">
            <option value="">-SELECT-</option>
            <?php
            $countries = getCountries();
            foreach ($countries as $code=>$cname) {
              echo "<option value=\"$code\">$cname</option>";
            }
            ?>
          </select>
        </div>

        <div class="form-group">
          <label for="exampleInputFile">Upload Avatar</label>
          <input type="file" name="avatar">
          <p class="help-block">(png,jpeg,bmp)</p>
        </div>

		<!-- Captcha Start -->
<img src="captcha/captcha.php" id="captcha" /><br/>
<a href="javascript:void(0)" onclick="    document.getElementById('captcha').src='captcha/captcha.php?'+Math.random();
    document.getElementById('captcha-form').focus();"
    id="change-image">Not readable? Change text.</a><br/><br/>
<input type="text" name="captcha" id="captcha-form" /><br/>
<!-- Captcha End-->

        <button type="submit" class="btn btn-primary btn-lg">I am done !!</button>
      </form>
      </div>

<?php  
 require_once('includes/footer.php');?>
